Individual
JESSICA BYRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3 COVENTRY LN, ATHENS, OH 45701-3717
(740) 501-7534
Mailing address
8595 HOON DR STE A, ATHENS, OH 45701-8892
(740) 501-7534
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
0300955
OH
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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